What is surveillance and why is it important?
Surveillance involves regular screenings and other tests depending on the specific cancer risk. Early detection through surveillance does not prevent cancer but can increase the chances of early intervention and successful treatment.
What are the different types of breast cancer surveillance?
Self breast exam:
A self-breast exam is a technique where individuals check their breasts for any changes or abnormalities, such as lumps or changes in texture or appearance. It involves using the fingers to feel for these changes, typically performed monthly, to detect potential breast health issues early. Our healthcare providers at UCSF are happy to teach you how to perform a self-breast exam and the signs to look out for.
Clinical breast exam:
A clinical breast exam is a physical examination performed by a healthcare provider to check for abnormalities in the breast tissue. During the exam, the provider feels both breasts and the surrounding lymph nodes to detect lumps, changes in size or shape, or other signs that may indicate breast cancer or other breast health issues.
MRI:
An MRI (Magnetic Resonance Imaging) for breast cancer screening creates detailed images of breast tissue using magnets and radio waves. MRIs can detect small tumors or abnormalities that may not be visible on mammograms, helping doctors diagnose breast cancer earlier and plan appropriate treatment.
Mammogram:
A mammogram for breast cancer screening uses X-rays to create images of breast tissue. Mammograms are good at detecting calcifications and masses, which are common signs of breast cancer.
When should someone with a BRCA1 or BRCA2 pathogenic variant start surveillance?
Breast cancer surveillance for people born female starts at around age 25. This included self breast exams, a clinical breast exam every 6 months, and a breast MRI once a year. Women should also have additional mammogram screenings when older. Prostate cancer surveillance for people born male starts at around 40. Our healthcare team at UCSF can help create a surveillance plan right for you based on your genetic testing results, family history, and other specific risk factors.
How accurate are the different types of surveillance methods for breast and ovarian cancer risk management?
MRIs can detect small tumors or abnormalities that may not be visible on mammograms or felt in a clinical breast exam, making MRI’s more reliable for catching breast cancer at early stages. However, given that MRI’s are more sensitive, people may experience false positives. A false positive is when an abnormality is found, but after further biopsy, is determined to not be cancer.
Ovarian cancer screening methods are currently not reliable for finding ovarian cancer in early stages. Typically, when ovarian cancer is found, it has developed to a later and more dangerous stage. Due to the screening limitations and ovarian cancer mortality rate, NCCN guidelines encourage people to consider risk-reducing surgeries to significantly reduce chances of getting ovarian cancer. To learn more about surgery for ovarian cancer risk reduction, click here.